Self Tracking in a Medical Context: The Quant Coach

1,376 views

Published on

Paul Abramson MD spoke at the Medicine X Conference 2012 at Stanford, on the topic of integrating self tracking approaches into his medical practice and implications for the larger health care system. The concept of a Quant Coach is introduced as an integral member of a medical team.

  • Be the first to comment

Self Tracking in a Medical Context: The Quant Coach

  1. 1. THE QUANTIFIED DOCTOR Self Tracking and Medical Care Paul Abramson MD My Doctor Medical Group UCSF Clinical Faculty @paulabramsonMD
  2. 2. “Many of the people who come to myoffice .. have come because modern medicine has failed them in some way, or they have used up its power to help them and they know not what else to do” -- Rachel Naomi Remen, MD
  3. 3. BS, MS Electrical Engineering
  4. 4. “the last bubble”MD
  5. 5. Rural - Urban - InternationalSmall Practice - Big Practice -District Hospital - University -Rural Clinic - Inpatient -Outpatient
  6. 6. WHAT’S WRONG WITH MY OWN HEALTH?
  7. 7. WHAT’S WRONG WITH HEALTH CARE? (partial list)•Conflicts of interest*•Ineffective for many things•Lack of interactivity and empowerment•Poor customer service
  8. 8. WHO MIGHT BENEFIT FROMA SELF-TRACKING PARADIGM?
  9. 9. Diagnosed medicalproblem not adequatelytreated by conventionalparadigm
  10. 10. Symptoms or syndromes notadequately diagnosed byconventional paradigm
  11. 11. Desire to identify environmental,food, contextual or socialcontributors to symptoms
  12. 12. Desire for behavior or lifestyle change
  13. 13. Or just a desire to be involvedin the process
  14. 14. A FEW HIGH-YIELD DIAGNOSES•Irritable •Psoriasis Bowel Syndrome •Addiction•Chronic Fatigue •Diabetes Mellitus•Noncardiac Chest Pain •Anxiety•Depression •Headaches
  15. 15. 2007-presentFounded My Doctor Medical Groupin San Francisco
  16. 16. THE PROMISE:GATHER DATA AND BENEFIT FROM FEEDBACK!
  17. 17. BUT MOST PEOPLECAN’T PULL IT OFF BY THEMSELVES(AND/OR HAVE A COMPLICATED MEDICAL ISSUE)
  18. 18. Doctor Quant Coach Self-TrackerOther Team Members Patient
  19. 19. THE QUANT COACH•A distinct member of the health care team•Different skill set from a doctor•Not burdened by the doctor-patient powerdifferential
  20. 20. SELF TRACKING CULTURE•Personal narrative•Iterative process•Specific problems and terminology
  21. 21. SELF TRACKING CULTURE •Choose appropriate tools •Reflection on specific incidents( Reflect - adjust - track ) insights and progress
  22. 22. DAVID 50 years old Engineer Stoic
  23. 23. DAVID3 month gradual onset Exertional but intermittent: Shortness of breath Chest discomfort “Palpitations”
  24. 24. DAVIDLabs EKG Echocardiogram Hospital admission Stress echo
  25. 25. DAVID “Everything is normal” So now what?
  26. 26. DAVID Dietary Sensitivity?Reflux? Work Stressor? Arrhythmia? Environmental trigger? Poor sleep? Panic Disorder?
  27. 27. Mymee App Dyspnea Chest Pain Cold Indoor Air Quality MeterPalpitations Dyspnea People Food Sleep EEG
  28. 28. Dyspnea
  29. 29. But it’s not really about the data
  30. 30. But it’s not really about the data It’s about the process
  31. 31. WHERE ARE WE NOW: BETA TESTING•Quant coaching in NYC - nonmedical•Quant coaching in Pittsburgh, PA - nonmedical•Quant coaching in SF - medically supervised (My Doctor Medical Group)
  32. 32. HOW TO FIX HEALTH CARE?Top down -- Electronic health exchange, “big data”analytics, performance measures, Accountable CareOrganizations, Patient Centered Medical Homes, apps forproviders and systems. Meh.
  33. 33. HOW TO FIX HEALTH CARE?Bottom up -- Self tracking, own your own data,quant coaching, personal experiments, doctor ascollaborator and consultant. Artful and appropriateuse of technology.
  34. 34. CONTACT MEPaul Abramson MDMy Doctor Medical Group San Francisco Tel 415-963-4431Twitter @paulabramsonmd ADN @paulabramsonmd mydoctorsf.com quantdoctor.com

×